Evaluation of Receptor Activator of Nuclear Factor Kappa-B Ligand and Osteoprotegerin Levels in Patients with Type 2 Diabetes Mellitus Treated with Oral Anti-diabetics ya da Insulin ile Tedavi Edilen Tip 2 Diabetes Mellituslu Hastalarda Reseptor Aktivator Nukleer Kappa-B Ligandi, Osteoprotegerin Duzeylerinin Kemik Dokusu Yonunden Incelenmesi

Introduction: We aimed to investigate the levels of receptor activator of nuclear factor kappa-b ligand (RANKL) and osteoprotegerin (OPG) in order to evaluate the negative effects of type 2 diabetes mellitus on bone health and their relationship to the severity of disease based on the treatment. We also evaluated the relationship between hemoglobin A1c (HbA1c), parathyroid hormone (PTH) and bone specific alkaline phosphatase (BAP) levels and RANKL and OPG levels. Methods: The study group consisted of 19 volunteers (15 females and 4 males) and 65 patients with type 2 diabetes mellitus (49 females and 16 males). In order to evaluate the relationship between the treatment and the disease severity, the patient group was divided into two subgroups: patients treated with oral anti-diabetics (OAD) (sulfonylurea and metformin) or insulin. The levels of glucose, calcium, phosphorus, HbA1c, BAP, PTH, RANKL and OPG were compared. Results: The RANKL and OPG levels of patients treated with insulin were significantly higher than the control group (p=0.008, p=0.033, respectively). However, there was no significant difference in the OAD group for both parameters (p=0.1, p=0.46, respectively). There was no significant difference between the groups in terms of PTH and BAP levels (p=0.97, p=0.66, respectively). Conclusion: We believe that RANKL and OPG levels are higher in patients with poor glycemic control and that they may be indicators of disease severity. Keywords: Insulin, metformin, osteoprotegerin, receptor activator of nuclear factor kappa-B ligand, sulfonylurea, type 2 diabetes mellitus Amac: Tip 2 diabetes mellitusun kemik sagligi uzerindeki olumsuz etkilerini, tedaviye bagli olarak hastaligin agirligi ile olan iliskisini degerlendirmek icin reseptor aktivator nukleer kappa-B ligandi (RANKL) ile birlikte osteoprotegerin (OPG) duzeylerini arastirdik. Ayrica hemoglobin A1c (HbA1c), paratiroid hormon (PTH), kemik spesifik alkalen fosfataz (BAP) duzeylerinin hem RANKL hem de OPG duzeyleri ile iliskisini degerlendirmektir. Yontemler: Calisma grubunu 19 gonulluden (15 kadin, 4 erkek), hasta grubunu ise 65 tip 2 diabetes mellituslu (49 kadin, 16 erkek) hasta olusturdu. Uygulanan tedavi ile hastalik agirligi arasindaki iliskiyi degerlendirebilmek icin hasta grubu oral anti diyabetik alan (sulfonilure, metformin) ya da insulin kullananlar olmak uzere iki alt gruba ayrilarak glikoz, kalsiyum, fosfor, HbA1c, BAP, PTH, RANKL, OPG duzeyleri karsilastirildi. Bulgular: Kan gliko